This study describes the incidence of irritable bowel syndrome (IBS) and its
association with antecedent infectious gastroenteritis among Millennium
Cohort Study participants using survey data and post-deployment health
assessments and medical encounter data in the military health system.
Consistent with other studies, the risk of IBS increased after acute enteric
infection. Novel findings included increased risk of incident IBS among
those with post-traumatic stress disorder (PTSD) and preceding life
stressors, as well as stronger associations between infectious
gastroenteritis and IBS among those with antecedent depression or anxiety.
These results reinforce the need to prevent acute gastrointestinal
infections and their chronic consequences among our Service members.
Additional studies on the underlying biopsychosocial mechanisms of IBS may
help to explain these findings.

Among military personnel, back pain is among the most frequent reasons for medical visits and lost duty time, and has been associated with pain-related disability. This study found that 15.5% of participants reported recent back pain at follow-up. Our study confirmed the high burden of this condition in the military, showing that deployers with combat experiences had a 38% higher odds of reporting back pain at follow-up, and 27% higher odds of repeated back pain, compared with deployers without combat experiences. Additionally, exposures associated with a physically demanding work environment were related to a higher risk of back pain. This well-defined group of military personnel would potentially benefit from integrated prevention efforts focused on mitigating and eliminating back pain over time.

Evaluation of a Modified Version of the Posttraumatic Growth Inventory-Short Form

BMC Research Methodology

2017 Apr;17(1):69

Kaur N, Porter B, LeardMann CA, Tobin TE, Lemus H, Luxton DD

This study sought to validate a modified measure of posttraumatic growth, personal growth, and change that may occur following trauma. Results indicate that this modified measure may be used to assess well-being at one time point or growth over two time points. Furthermore, the two items assessing spirituality had a strong relationship with each other and may be used alone in future studies.

This study describes the incidence of and risk factors for two pathotypes of inflammable bowel disease (IBD), Crohn’s Disease (CD) and ulcerative colitis (UC) among Millennium Cohort Study participants using survey responses as well as data from post-deployment health assessments and medical encounters in the Military Health System. We observed that CD risk predictors included current smoking, two life stressors (vs. none), and prior irritable bowel syndrome. For UC, a dose-response relationship between the risk of UC and an increasing number of life stressors was observed. Antecedent infectious gastroenteritis was associated with an almost three-fold increase in risk in UC, but was not associated with CD. Stressful conditions along with infectious gastroenteritis are usual features of any deployment operation and may play a role in the development of IBD. However, observed differences in risk factors for UC and CD warrant further investigation.

Among Servicewomen aged 18-45 years, 31% reported a miscarriage and 11%
reported impaired fecundity (infertility) during a 3-year study period.
Findings suggest that deployments in support of the operations in Iraq and
Afghanistan do not increase the risk for miscarriage and infertility among
U.S. Servicewomen. More research is needed to better understand whether
specific combat experiences or environmental exposures encountered during
deployments increase the risk for adverse reproductive health outcomes.

This study compared trajectories of PTSD symptoms between separated and continuously serving Active Duty participants. Trajectories among both groups were highly similar and separated into four classes: resilient, delayed-onset, improving, and elevated-recovering. Resilient trajectories (i.e., having low PTSD symptoms throughout the study period) were the most common trajectory in both groups, although they were less common among separated (82%) compared with continuously serving (87%) personnel. Interventions targeted toward individuals with delayed-onset trajectories may prevent sub-clinical PTSD
from worsening.

Following sexual assault while serving in the military, women had double the risk for unhealthy alcohol use relapse while men had 6 times the risk for smoking relapse compared with women and men who did not experience sexual assault, respectively. No other associations between sexual trauma (assault or harassment) and subsequent smoking or unhealthy alcohol use were observed. Substance use prevention measures are recommended for those who experience sexual assault and have a history of smoking and unhealthy alcohol use.

This study compared two measures of combat exposure and showed that both measures were similarly predictive of poor mental health. The unique contributions of specific exposures to poor mental health were also examined. While all combat exposure items were related to poor mental health, relatively stronger independent associations were observed for certain exposures (e.g., witnessing instances of physical abuse).

Factors Associated With Persistent Posttraumatic Stress Disorder Among U.S. Military Service Members and Veterans

BMC Psychiatry

2018 Feb 17;18(1):48

Armenta RF, Rush T, LeardMann CA, Millegan J, Cooper AD, Hoge, CW

Among service members and veterans who screened positive for PTSD at baseline, 47% met the criteria for persistent PTSD. Combat experiences and PTSD severity were found to be the most salient factors associated with persistent PTSD; other associated factors included co-morbid conditions, sleep problems, and somatic symptoms. These findings corroborate the need for more comprehensive and accessible treatment to address both PTSD symptoms and comorbid conditions.

A Decade of War: Prospective Trajectories of Posttraumatic Stress Disorder Symptoms Among Deployed US Military Personnel and the Influence of Combat Exposure Reply

American Journal of Epidemiology

2018 May 4;187(7):1570-1575

Donoho CJ, Bonanno GA, Porter B, Kearney L, and Powell TM

Details the reasons that the results found in "A decade of war: Prospective trajectories of post-traumatic stress disorder symptoms among deployed US military personnel and the influence of combat exposure" are not likely to be confounded by mefloquine side effects.

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The Millennium Cohort Study is an authorized Department of Defense project at the Deployment Health Research Department, located at the Naval Health Research Center, in San Diego, California. OMB Control #: 0703-0064/RCS: DD-NAVY(AR)2678, and Primary Institutional Review Board Protocol # Naval Health Research Center.2000.0007.